PROVIDENCE DENTAL SPA OF NEWNAN LLC NPI 1679231831

NPI Information

NPI: 1679231831
Provider Name: PROVIDENCE DENTAL SPA OF NEWNAN, LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
166 JEFFERSON PKWY
NEWNAN, GA
ZIP 30263
Phone: (770) 252-1300
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PROVIDENCE DENTAL SPA OF NEWNAN, LLC is a dental clinic center in Newnan, GA. PROVIDENCE DENTAL SPA OF NEWNAN, LLC NPI is 1679231831. The provider is registered as an organization entity type.

The provider's business location address is:

166 JEFFERSON PKWY
NEWNAN, GA
ZIP 30263-822
Phone: (770) 252-1300
Fax: (770) 252-1763

The provider's authorized official is Paul Jason Mann .
The authorized official title is Managing Partner and has the following contact phone number (770) 550-7741.

The enumeration date for this NPI number is 12/6/2021 and was last updated on 12/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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